<!DOCTYPE html>
<html xmlns="http://www.w3.org/1999/xhtml" xmlns:th="http://www.thymeleaf.org">
	<head>
		<meta charset="utf-8">
		<meta name="viewport" content="initial-scale=1, maximum-scale=1, user-scalable=no">
		<meta name="format-detection" content="telephone=no">
		<title>管理员报名</title>
		<link rel="stylesheet" href="/css/frozen.css">
		<link rel="stylesheet" href="/css/webuploader.css" />
	</head>

	<body ontouchstart>
		<section class="ui-container">
			<section id="form">
				<div class="demo-item">
					<div class="ui-form-item ui-border-b">
						<h1>管理员基本信息</h1>
					</div>
					<div class="demo-block">
						<div class="ui-form ui-border-t">
							<form action="#">
								<div class="ui-form-item ui-border-b">
									<label>残疾人证号</label>
									<input type="text" placeholder="残疾人证号码" />
									<a href="#" class="ui-icon-close">
									</a>
								</div>
								<div class="ui-form-item ui-border-b">
									<label>姓名</label>
									<input type="text" placeholder="请输入真实姓名" />
									<a href="#" class="ui-icon-close">
									</a>
								</div>
								<div class="ui-form-item ui-border-b">
									<label>身份证</label>
									<input type="text" placeholder="18位身份证号码" />
									<a href="#" class="ui-icon-close">
									</a>
								</div>
								<div class="ui-form-item ui-border-b">
									<label>出生日期</label>
									<div class="ui-select-group">
										<div class="ui-select">
											<select>
												<option>2014</option>
												<option selected>2015</option>
												<option>2016</option>
											</select>
										</div>
										<div class="ui-select">
											<select>
												<option>03</option>
												<option selected>04</option>
												<option>05</option>
											</select>
										</div>
										<div class="ui-select">
											<select>
												<option>21</option>
												<option selected>22</option>
												<option>23</option>
											</select>
										</div>
									</div>
								</div>
								<div class="ui-form-item ui-border-b">
									<label>性别</label>
									<div class="ui-flex ui-flex-pack-center">
										<label class="ui-radio" for="radio">
		                            	男  <input type="radio" name="radio" />
		                            	女  <input type="radio" checked="" name="radio" />
		                      		</label>
									</div>
								</div>
								<div class="ui-form-item ui-border-b">
									<label>残疾类别</label>
									<div class="ui-select">
										<select>
											<option>视力</option>
											<option selected>听力</option>
											<option>嗅觉</option>
										</select>
									</div>
								</div>
								<div class="ui-form-item ui-border-b">
									<label>民族</label>
									<div class="ui-select">
										<select>
											<option>汉族</option>
											<option selected>回族</option>
											<option>其他</option>
										</select>
									</div>
								</div>
								<div class="ui-form-item ui-form-item-textarea ui-border-b">
									<label>办证地区</label>
									<textarea placeholder="街道等详细地址"></textarea>
								</div>
								<div class="ui-form-item ui-border-b">
									<label>户口状况</label>
									<div class="ui-select">
										<select>
											<option>未知</option>
										</select>
									</div>
								</div>
								<div class="ui-form-item ui-border-b">
									<label>婚姻状况</label>
									<div class="ui-select">
										<select>
											<option>未知</option>
										</select>
									</div>
								</div>
								<div class="ui-form-item ui-border-b">
									<label>图片上传</label>
									<input type="file" />
								</div>
								<div class="ui-form-item ui-btn-wrap">
								    <button class="ui-btn ui-btn-primary">
								        确定
								    </button>
								    <button class="ui-btn ui-btn-primary" disabled>
								        取消
								    </button>
								</div>
			</section>
		</section>
		
	</body>

</html>